Laserfiche WebLink
r <br /> � 8'13-780-0020 CIf}r Of�E(J�iyi'�'111�5�lFE��-�.�=,:: Fax-813-780-0021 <br /> � Permit Applicatinn <br /> Qate Received � Phorie Contact�for Permif �_ <br /> ' Owner's Name �. `j�Q'O� Owriets Phone Number .�� �� �� <br /> Owner's Atldress . /���� ��,�� �L'�� ` ' , ' <br /> - f <br /> , Fee Simple'T'itleholder Name - � ?itleholder Phone Nurrm6er � � � <br /> I Fee-Simpte Ti#iehatder Address - ` - <br /> � <br /> .3ob Address Lat# ' �_`� <br /> 5ub Division Rarcei# - � _ <br /> i - - <br /> � � Bio-Hazard Waste Starage=•ANNUAL v�, �' Fumigation Tent �� <br /> ''�n <br /> I � Gomm Ezhsus#Kitohen NoodlDtrct � Hazardou's Matedal{Tier tl or RQ�acIlity)ANNUAL <br /> ' Q Controlled 8um � Hood Installation. <br /> � Emergency Generator{30 kw � LPilVaturai�as-lnstaliation <br /> � , Emeryency Generator>30 kw � LP/Naturai Gas-ANNUAL 5aie <br /> ' Q �Firs Protection Maintenance-�ANNUAL � Plaaes of Assembiy-ANNUAL <br /> �t r y. emt Ari er � <br /> 5prinkler � ❑ p ❑ � � Recrsational Bum ��j � <br /> �ire Alarm � Ci ❑ O � Q �Sparklers. �`� <br /> Hood Cleaning � ❑ ❑ ❑ � � 5prinkier 5ystem installations <br /> Hood Suppression � D � ❑ �� � Standpipes(Sprinkler 5ys) <br /> � Fire Alartn Installation � 7orch Roofingliar FtetUe <br /> � Fise Pgmps � Was#e Tire Sfa�age ANFIUAL <br /> Fire Warks, <br /> � Flammabte Appi�cation-ANt�UAL VgEtta�lpit Of PTaj�C� <br /> °� Fuel7anks � � � <br /> Q OtFter: . <br /> Contractor j/ - Compariy , ��/��,�;�__����(���__�4' � <br /> Signature �j Registered j Y/N Fee Cu nt Y/N <br /> Address /' � � � � - license# <br /> ELEC7RICIAN � � Campany �_� <br /> 5ignature Registered Y/N Fee Gurrent Y/�� <br /> Address , License# <br /> PLUINBER � Company " <br /> Signature _ _ Registered_ ; .Y/N� _ Fee CurtenY Y/N . � <br /> Address � - . License# " - <br /> MECHANICAL Company ���� <br /> 5ignature Ragistered Y!N Fee Currenf Y/N <br /> Address � <br /> Ucense# <br /> OTHER Gompany� - <br /> Signature Registered Y/N Fee Currant Y/N <br /> Addr�ss . <br />� - License# <br /> DirecGons: <br /> ._� - -_.. _. _...._ ___ . <br /> RII out application completely. <br /> IOmrer&Corstrac#or slgn back af app3icefion,notarized{Or,copy of signed contract with owner} <br /> tf over$250Q,a Notice of CommencemenYis required.(Mechanical woric over$5000} <br /> 5upply 1wo(2)sets of drawings wlth applicable documentaUon� <br /> Ailow 9 0-14 days for raview after su6mittaf date. Parce{#-obtained from Properiy T�No6ce(httpJ/appcaisec.pascogov.com} <br />